Macedo-Viñas Marina, Denning David W
Sistema Nacional de Investigadores, Agencia Nacional de Investigación e Innovación, Montevideo 11500, Uruguay.
National Aspergillosis Centre, Wythenshawe Hospital and The University of Manchester, Manchester M13 9PL, UK.
J Fungi (Basel). 2018 Mar 18;4(1):37. doi: 10.3390/jof4010037.
We aimed to estimate for the first time the burden of fungal infections in Uruguay. Data on population characteristics and underlying conditions were extracted from the National Statistics Institute, the World Bank, national registries, and published articles. When no data existed, risk populations were used to estimate frequencies extrapolating from the literature. Population structure (inhabitants): total 3,444,006; 73% adults; 35% women younger than 50 years. Size of populations at risk (total cases per year): HIV infected 12,000; acute myeloid leukemia 126; hematopoietic stem cell transplantation 30; solid organ transplants 134; COPD 272,006; asthma in adults 223,431; cystic fibrosis in adults 48; tuberculosis 613; lung cancer 1400. Annual incidence estimations per 100,000: invasive aspergillosis, 22.4; candidemia, 16.4; peritonitis, 3.7; pneumonia, 1.62; cryptococcosis, 0.75; severe asthma with fungal sensitization, 217; allergic bronchopulmonary aspergillosis, 165; recurrent vaginitis, 6323; oral candidiasis, 74.5; and esophageal candidiasis, 25.7. Although some under and overestimations could have been made, we expect that at least 127,525 people suffer from serious fungal infections each year. Sporothrichosis, , paracoccidioidomycosis, and dermatophytosis are known to be frequent but no data are available to make accurate estimations. Given the magnitude of the burden of fungal infections in Uruguay, efforts should be made to improve surveillance, strengthen laboratory diagnosis, and warrant access to first line antifungals.
我们旨在首次估算乌拉圭真菌感染的负担。有关人口特征和基础疾病的数据来自国家统计局、世界银行、国家登记处及已发表的文章。若没有相关数据，则利用风险人群，根据文献推断来估算感染频率。人口结构（居民）：总计3,444,006人；73%为成年人；35%为50岁以下女性。风险人群规模（每年的病例总数）：艾滋病毒感染者12,000人；急性髓细胞白血病患者126人；造血干细胞移植患者30人；实体器官移植患者134人；慢性阻塞性肺疾病患者272,006人；成年哮喘患者223,431人；成年囊性纤维化患者48人；结核病患者613人；肺癌患者1400人。每10万人的年发病率估算值：侵袭性曲霉病为22.4；念珠菌血症为16.4；腹膜炎为3.7；肺炎为1.62；隐球菌病为0.75；真菌致敏的重度哮喘为217；变应性支气管肺曲霉病为165；复发性阴道炎为6323；口腔念珠菌病为74.5；食管念珠菌病为25.7。尽管可能存在一些低估和高估的情况，但我们预计每年至少有127,525人患有严重的真菌感染。已知孢子丝菌病、副球孢子菌病和皮肤癣菌病较为常见，但尚无数据进行准确估算。鉴于乌拉圭真菌感染负担的规模，应努力加强监测、强化实验室诊断并确保一线抗真菌药物的可及性。
